

<!--WSTAG name="prog_suivant" -->
<script src="/sites/all/themes/parvis_v2/js/jquery-1.6.min.js" type="text/javascript"></script>
<script src="/sites/all/themes/parvis_v2/js/jquery.validationEngine-fr.js" type="text/javascript" charset="utf-8"></script>
<script src="/sites/all/themes/parvis_v2/js/jquery.validationEngine.js" type="text/javascript" charset="utf-8"></script>
<script type="text/javascript" src="/sites/all/themes/parvis_v2/js/jquery.jqtransform.js" ></script>
<link rel="stylesheet" href="/sites/all/themes/parvis_v2/css/jqtransform.css" type="text/css" media="all" />
<link rel="stylesheet" href="/sites/all/themes/parvis_v2/css/template.css" type="text/css"/>


<script language="javascript">
		jQuery(document).ready(function(){
			// binds form submission and fields to the validation engine
			jQuery("#form").validationEngine({autoHidePrompt:true, autoHidePromptDelay:500});
		});
</script>

<!--WSTAG name="texte1" -->
<form id="form" class="formular" method="post" action="" name="forec" class="niceform">
  <!--WSTAG name="texte2" -->
<fieldset>
			<legend>
				<!--WSTAG name="lab_numero" --> : <!--WSTAG name="numero_cli" -->
			</legend>

    <label class="full">
		<span class="mandatory">*</span> <!--WSTAG name="lab_civil" -->
		<input type="text" id="nomf4" name="civilf" class="validate[required] text-input">
	</label>
	<label>
		<span class="mandatory">*</span> <!--WSTAG name="lab_nom" -->
		<input type="text" id="nomf3" name="nomfx" class="validate[required] text-input">
	</label>
	<label>
		<span class="mandatory">*</span> <!--WSTAG name="lab_prenom" -->
		<input type="text" id="nomf33" name="nomfxx" class="validate[required] text-input">
	</label>
       
	<label>
		<span class="mandatory">*</span> <!--WSTAG name="lab_adresse" -->
		<input type="text" id="adr1f" name="adr1f" class="validate[required] text-input">
		<input name="adr2f" type="text" id="adr2f" class="text-input">
		<input name="adr3f" type="text" id="adr3f" class="text-input">
	</label>
	<label>
		<span class="mandatory">*</span> <!--WSTAG name="lab_local" -->
		<div>
			<input name="nopostf" type="text" id="nopostf" maxlength="10" class="validate[required,custom[integer]] text-input">
			<input name="localf" type="text" id="localf" maxlength="50" class="validate[required] text-input">
		</div>
	</label>
	<label>
		<span class="mandatory">*</span> <!--WSTAG name="lab_pays" -->
		<select size="1" id="paysf"  name="paysf" class="validate[required]">
        </select>
	</label>
	<label>
		<span class="mandatory">*</span> <!--WSTAG name="lab_mail" -->
		<input type="text" id="mailf" name="mailf" class="validate[required,custom[email]] text-input" value="">
	</label>
	<label>
		<!--WSTAG name="lab_tel" -->
		<input type="text" id="telf" name="telf" class="text-input">
	</label>
	<label>
		<span class="mandatory">*</span><!--WSTAG name="lab_passw1" -->
		<input name="passw1" type="password" id="passw1" class="validate[required,minSize[6]] text-input">
	</label>
	<label>
		<span class="mandatory">*</span><!--WSTAG name="lab_passw2" -->
		<input name="passw2" type="password" id="passw2" class="validate[required,equals[passw1]] text-input">
	</label>

	<label class="full">
		<input type="checkbox" name="news" id="news" class="validate[required] checkbox">
		<span class="checkbox"><!--WSTAG name="lab_news" --></span>
	</label>
	<label class="full">
  <!--WSTAG name="navigation" -->
	</label> 
  
  <input type="hidden" name="FRowid"  value="?">
  <input type="hidden" name="LRowid"  value="?">
  <input type="hidden" name="lang" value="10">
  <input type="hidden" name="par-prog" value="?">
</form>

<!--WSTAG name="erreur" -->

<!--WSTAG name="texte3" -->

<!--WSTAG name="err_adr" -->
<!--WSTAG name="lab_mobli" -->
<!--WSTAG name="lab_natel" -->
<input name="natelf" type="text" id="natelf" size="30" maxlength="80">
<!--WSTAG name="err_pwd" -->